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Individual

DR. JOLYN INEZ TATUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
42D MEDICAL GROUP, 300 S. TWINING ST., BLDG 760, MAXWELL AFB, AL 36112-6027
(334) 953-5200
Mailing address
42D MEDICAL GROUP, 300 S. TWINING ST., BLDG 760, MAXWELL AFB, AL 36112-6027
(334) 953-5200

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
B1-0000907
DE
103TH0004X
Health Psychologist
Primary
B1-0000907
DE

Other

Enumeration date
03/30/2009
Last updated
11/15/2024
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